Cent Eur J Nurs Midw 2025, 16(1):2085-2093 | DOI: 10.15452/cejnm.2025.16.0001

Examining the connection between perceived stress and post-traumatic stress in women who experienced a traumatic childbirth

Sónia Brandão1, Rosa Silva1, Wilson Abreu1, Tânia Brandão2, Ana Paula Prata1, Olga Riklikiene3, Gabija Jarasiunaite-Fedosejeva4, Ernesto González Mesa5, Gözde Gökçe İsbir6, Figen İnci7, Burcu Kömürcü-Akik8, Kristiina Uriko9, Tatiana Governo10, Gill Thomson11
1 RISE-Health, Nursing School of Porto, Porto, Portugal
2 William James Center for Research, ISPA – Instituto Universitário, Lisboa, Portugal
3 Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
4 Department of Psychology, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
5 Department of Surgical Specialties, Biochemistry and Immunology, University of Malaga, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA-Plataforma BIONAND), Research Group in Maternal-Fetal Medicine, Epigenetics, Women’s Diseases and Reproductive Health, Spain
6 Midwifery Department, Faculty of Health Sciences, Mersin University, Yenişehir, Mersin, Turkey
7 Zübeyde Hanım Faculty of Health Sciences, Niğde Ömer Halisdemir University, Niğde, Turkey
8 Department of Psychology, Faculty of Language, History and Geography, Ankara University, Ankara, Turkey
9 School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
10 Santo António Local Health Unit, EPE, Porto, Portugal
11 Maternal, Parental and Infant Nutrition & Nurture research unit, School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom

Aim: This study aimed to: (1) explore post-traumatic stress disorder symptoms in relation to sociodemographic, obstetric, and childbirth trauma factors; (2) assess the association between perceived stress levels and post-traumatic stress disorder symptoms; and (3) analyze how the duration of perceived stress affects post-traumatic stress disorder.

Design:  A cross-sectional study.

Methods: Data were collected via an online survey, including demographic and obstetric information, traumatic childbirth events, post-traumatic stress disorder symptoms, and perceived stress levels and duration in the postpartum period. The study was conducted with 202 women who self-identified as having experienced a traumatic childbirth.

Results: Post-traumatic stress disorder scores did not differ significantly by most sociodemographic or obstetric factors, but cesarean delivery was linked to higher post-traumatic stress disorder scores compared to vaginal delivery with forceps or vacuum extraction, mediated by increased perceived stress. Perceived stress levels showed a significant positive association with all post-traumatic stress disorder dimensions. Stress duration significantly was related to total post-traumatic stress disorder scores, with longer stress being associated with greater severity of symptoms.

Conclusion:  Cesarean delivery and prolonged, elevated stress during childbirth are key risk factors for post-traumatic stress disorder symptoms, highlighting the need for targeted postpartum mental health interventions.

Keywords: childbirth trauma, perceived stress, post-traumatic stress disorder, woman

Received: August 5, 2024; Revised: December 22, 2024; Accepted: January 8, 2025; Published: March 6, 2025  Show citation

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Brandão S, Silva R, Abreu W, Brandão T, Prata AP, Riklikiene O, et al.. Examining the connection between perceived stress and post-traumatic stress in women who experienced a traumatic childbirth. Central European Journal of Nursing and Midwifery. 2025;16(1):2085-2093. doi: 10.15452/cejnm.2025.16.0001.
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